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KMID : 0359420030210010001
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Korean Journal of Sports Medicine
2003 Volume.21 No. 1 p.1 ~ p.12
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Clinical Outcome of Arthroscopic Anterior Shoulder Stabilization: Two to Six-Year Follow-up
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Kim Seung-Ho
Ha Kwon-Ick
No Kyu-Cheol
Ryu Byung-Dam
Oh Ir-Vin
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Abstract
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The purposes of this study were to prospectively evaluate the surgical outcome of the arthroscopic repair of the capsulolabral lesion using suture anchors in a large series of patients who were followed-up for mid-term periods. We evaluated 167 patients with traumatic recurrent anterior shoulder instability after an arthroscopic Bankart repair using suture anchors and nonabsorbable sutures. The mean age at the time of the operation was 25 years (15~46 years). There were 149 male and 18 female patients. Preoperatively and at the time of follow-up(mean, 44 months; range, 24~75 months), three objective outcome measurement tools(Rowe Score, University of California at Los Angeles Shoulder rating scale, and American Shoulder and Elbow Surgeons score) and two subjective measurements(pain and function visual analogue scale) were assessed. The recurrence rate, range-of-motion, and risk factor for postoperative recurrence were evaluated. All shoulder scores improved after surgery(t-test, p<0.05). According to the Rowe scale, One hundred and thirty patients(78%) showed excellent, 29(17%) good, 6(4%) fair, and 2(2%) poor scores. Overall, postoperative recurrence of the instability was 4%(1 dislocation, 2 subluxation, and 4 positive anterior apprehensions). Postoperative recurrence was related with the glenoid defect of greater than 30%(Gehan’s test, p<0.0001). In patients with postoperative instability, the recurrent episode was less frequent and shoulder function was related with the activity level(Fisher’s Exact test, p=0.029). Revision arthroscopic Bankart repair stabilized 3 out of 4 patients. Patients’ activities were increased after the surgery(t-test, p<0.001). One hundred and fifty-two patients(91%) returned to more than 90% of previous activities. The mean loss of external rotation was 2.0±4.0°. In contrast to the previous reports on the results of the arthroscopic repair, arthroscopic capsulolabral repair using suture anchors provided satisfactory outcomes in terms of the recurrence, activity, and range of motion.
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KEYWORD
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Shoulder, Anterior instability, Bankart repair, Suture anchor
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